Autism spectrum disorder (ASD) and its early diagnosis via infant behavior measurements

Efforts to detect autism spectrum disorder before the age of two mostly rely on parental reports, as opposed to infant behavior. Measuring infant behavior, however, directly provides vital information that may make a diagnosis of ASD possible in infants as young as 12 months.

Understanding ASD

Society’s attitude and understanding of autism spectrum disorder (ASD) have radically changed over the last 50 years. Previously considered a narrowly-defined and rare disorder of childhood onset, ASD is now a broadly advocated, well-publicized, and intensively researched lifelong condition. 

ASD is understood to be common and highly heterogeneous in that its severity and characteristics show significant variance from person to person.

The core features of ASD are issues with social communication (both verbal and nonverbal), as well as repetitive or restricted sensory-motor behaviors.1 In most cases, ASD manifests in infant behavior and is believed to strongly associate with environmental factors and certain genetic components (though the causes remain poorly understood). 

ASD is considered a lifelong condition, though a change in this perception is beginning to show as the efficacy of early interventions becomes more established.2

There has been a dramatic improvement in the outlook for people with ASD. There has been an increase in the number of people with ASD who can read, speak, drive and live outside of institutions, and by adulthood, symptoms will be largely reduced for many.

For the most part, however, individuals with ASD will not work full time or live independently, often requiring support.

Detection and diagnosis of ASD

There are no reliable biomarkers for ASD, so diagnosis is instead dependent on the assessment of infant behavior and development. An experienced professional can typically diagnose ASD in children aged two years or older.3,4 ASD may be observed earlier; however, many children do not receive a final diagnosis until they are significantly older.

Early diagnosis of ASD is considered positive as it means that intervention can be more timely and, thus, more effective.5,6 It is suggested in several studies that low-intensity coaching of parents on how to interact with young children with ASD can give immediate benefits to their behavior and communication skills.7 

Other research indicates that interventions based on applied behavior analysis (ABA) – the most common therapy for ASD – benefit from an early start.8 The exploration of the effects of ASD on infant behavior in children under two is an active area of research.

Investigating ASD in young infants

While infant behavior is the primary concern of ASD research in infants, it is uncommon in most efforts to investigate ASD in infants younger than two through direct observation of infant behavior. Instead, parental reports are relied upon as a source.9

Recent research reveals that directly recording and analyzing infant behavior can provide a wealth of information that parental reports cannot.

A study by Gangi et al. demonstrated that detecting ASD in children as young as 12 months of age is possible by observing infant behavior.10 In the study, researchers used behavioral observation software to monitor infant gaze on the face of an adult. 

Recording both infant and adult behavior on camera, the researchers could compare gaze-to-face infant behavior in two social contexts: structured testing with an unfamiliar examiner and semi-structured play with a parent.

The researchers observed that infants who would not go on to be diagnosed with ASD would gaze more at their parent’s face during play than at the examiner’s face during testing. In contrast, infants who were later diagnosed with ASD through the use of ADOS-2 were not affected by context. 

These results could indicate that infants developing ASD may be less sensitive to interactive partners or social contexts. The study strongly supports the validity of the direct assessment of infant behavior in structured laboratory settings as a method of investigating ASD.

Another study by Sacrey et al. monitored infant behavior in relation to ASD by using automated behavioral coding software. In this study, researchers recorded differences in infant behavior in emotion-evoking tasks between two groups at 12 and 18 months: infants with an “increased likelihood” of developing ASD (i.e., an older sibling with ASD) and infants with a“lower likelihood” of developing ASD (i.e., no family history of ASD).

Through the use of behavioral coding software, the researchers were able to assess infant behavior automatically. The effect was coded in five-second intervals based on both vocal and facial cues. In contrast, gaze was coded continuously – providing a simple means of characterizing infant behavior throughout the tasks. 

These infant behaviors, coded as affect and gaze scores, predicted ASD symptoms at 24 months.

Image Credit: Ground Picture/ Shutterstock 

Automatically measuring infant behavior

Behavioral responses provide important information that supports parental reports of emotional regulation, providing a more comprehensive assessment of infant behavior.

At Noldus, systems are developed to make sophisticated behavior research simple. The Observer XT enables researchers to code behaviors on a timeline and efficiently conduct thorough analyses, making it the most complete software in Noldus’ portfolio for human behavioral research.

Noldus also provides a suite of alternative software solutions for behavior tracking: from Baby FaceReader, a version of Noldus’ standard FaceReader emotion classification software explicitly developed for infant behavior analysis, to Viso, an audio and video recording suite.

All software tools provided by Noldus are easily integrated, allowing researchers to integrate audio, video, and eye tracking data into a powerful software package for analysis.

As well as standalone tools, Noldus develops custom-built infant behavior labs. Integrating cameras, eye trackers, computers, and physiological measurement systems to meet the needs specific to individual research in infant behavior, Noldus enables comprehensive and accurate data collection that is ready for publication.

Noldus recognizes that unobtrusive observation can be critical in behavioral research. From observation labs replicating natural home conditions to portable labs deployed in a naturalistic environment, Noldus can provide a variety of discrete behavior tracking solutions that enable the study of infant behavior with minimal stress or influence on the subjects.

To find out more about the behavior tracking systems or customized turn-key labs from Noldus? Get in touch with Noldus today.

References and further reading

  1. Lord, C., Elsabbagh, M., Baird, G. & Veenstra-Vanderweele, J. Autism spectrum disorder. Lancet 392, 508–520 (2018).
  2. Orinstein, A. et al. Intervention for Optimal Outcome in Children and Adolescents with a History of Autism. Journal of developmental and behavioral pediatrics : JDBP 35, 247–56 (2014).
  3. ​CDC. Basics About Autism Spectrum Disorder (ASD) | NCBDDD | CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/facts.html (2022).
  4. ​Lord, C. et al. Autism From 2 to 9 Years of Age. Arch Gen Psychiatry 63, 694 (2006).
  5. ​Dillenburger, K. Why early diagnosis of autism in children is a good thing. The Conversation. http://theconversation.com/why-early-diagnosis-of-autism-in-children-is-a-good-thing-33290.
  6. ​Children, Y. & Corsello, C. M. Early Intervention in Autism. (2005).
  7. ​Weitlauf, A. S. et al. Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update. (2014).
  8. ​Peters-Scheffer, N., Didden, R., Korzilius, H. & Sturmey, P. A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with autism spectrum disordersDatabase of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] (Centre for Reviews and Dissemination (UK), 2011).
  9. ​Sacrey, L.-A. R. et al. Affect and gaze responses during an Emotion-Evoking Task in infants at an increased likelihood for autism spectrum disorder. Molecular Autism 12, 63 (2021).
  10. ​Gangi, D. N. et al. Gaze to faces across interactive contexts in infants at heightened risk for autism. Autism 22, 763–768 (2018).

About Noldus Information Technology

Noldus Information Technology was established in 1989 by Lucas Noldus, founder and CEO of the company. With a Ph.D. in animal behavior from Wageningen University, he developed the company’s first software tool during his research in entomology. Noldus has strived to advance behavioral research ever since, evolving into a company that provides integrated systems including software, hardware, and services.

We now offer a wide range of solutions for research in animal and human domains, including biology, psychology, marketing, human factors, and healthcare. We work with leading suppliers and develop innovative, state-of-the art products. We also offer excellent technical support and customer care. As a result, our systems have found their way into more than 10,200 universities, research institutes, and companies in almost 100 countries.

The success of our company is determined to a large extent by the enthusiasm and creativity of our employees. We encourage each other to think outside the box, which leads to unique products and services for our customers. And we are always on the lookout for new talent!


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Last updated: Nov 29, 2022 at 5:27 AM

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